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Fluphenazine

Trifluperazine

Thioridazine

Depress both respiratory and vasomotor centre

Ketamine increase ICP So CI in head injury

CNS depression

Barbiturate GABA mimetic agent

Highly lipid soluble Highly alkaline Highly irritant Highly perfused organ

Advantage No irritation of respiratory passage Antiemetic effect Rapid induction and recovery

Disadvantage Respiratory depression Fall in BP Acidosis Increase blood lipid level Pain

Sympathetic stimulation

Porphyria

ISOFLURANE does not sensitize the heart to catecholamines Haltohane sensitizes the heart to catecholamines resulting in arrhythmias

Negligible toxic

HR inc CO maintained BP fall

Thiopentone has anticonvulsant properties Propofol used in status epilepticus

Thiopentone Poor analgesic Laryngospasm Ketamine Good analgesic Bronchodilation

Highly lipid soluble ( rapid onset , short duration , redistribution) Highly alkaline Highly irritant Highly perfused organ ( Brain liver heart )

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Sedation Marked analgesia Amnesia Unresponsive to commands Dissociation from surrounding

Second gas effect MAC decreased Less side effect Rapid recovery Potential anaesthetic and good analgesia

Halothane Margin of safety is not wide Expensive Adverse effect 4H Hypotension malignant Hyperthermia Hepatotoxic sensitises Heart to catecholamines- arrhythmias

The coronary steal phenomenon is a complex cardiovascular condition: # Definition The coronary steal phenomenon occurs when there is a redirection of blood flow in the coronary arteries, leading to a decrease in blood flow to a specific area of the heart muscle. # Mechanism 1. *Vasodilation*: In response to certain stimuli, such as exercise or emotional stress, blood vessels in the heart dilate. 2. *Blood flow redistribution*: As a result of vasodilation, blood flow is redirected from areas of the heart with compromised blood flow (e.g., due to coronary artery disease) to areas with normal blood flow. 3. *Decreased blood flow*: The area with compromised blood flow receives even less blood, leading to ischemia and potentially causing symptoms such as chest pain. # Causes 1. *Coronary artery disease*: Narrowing or blockage of the coronary arteries can lead to the coronary steal phenomenon. 2. *Cardiac shunts*: Abnormal connections between blood vessels in the heart can cause blood flow redistribution. 3. *Vasodilatory medications*: Certain medications, such as nitroglycerin, can cause vasodilation and lead to the coronary steal phenomenon. # Clinical presentation 1. *Chest pain*: The most common symptom, often described as a squeezing or pressure sensation. 2. *Shortness of breath*: Decreased blood flow to the heart muscle can lead to respiratory distress. 3. *Fatigue*: Reduced blood flow can cause feelings of weakness and tiredness. # Diagnosis 1. *Electrocardiogram (ECG)*: To assess heart rhythm and detect signs of ischemia. 2. *Stress test*: To evaluate heart function during physical activity. 3. *Coronary angiography*: To visualize the coronary arteries and detect blockages. # Treatment 1. *Medications*: To manage symptoms, such as beta blockers, calcium channel blockers, or nitrates. 2. *Revascularization*: Procedures like angioplasty or coronary artery bypass grafting to restore blood flow. 3. *Lifestyle modifications*: To reduce cardiovascular risk factors, such as exercise, diet, and stress management. Would you like: 1. More information on coronary artery disease? 2. Discussion on the management of cardiac shunts? 3. Explanation of vasodilatory medications and their effects? 4. Information on the role of stress testing in diagnosing coronary steal phenomenon?

Cornary steal phenomenon

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Mam ap lab diagnosis nahi padhi pls complete kar dijiye..

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Differences between Penicillin G and Amoxicillin: 1. Spectrum of Activity • Penicillin G: Narrow-spectrum, mainly effective against Gram-positive bacteria. • Amoxicillin: Broad-spectrum, effective against Gram-positive and some Gram-negative bacteria. 2. Route of Administration • Penicillin G: Given IV or IM (acid-labile, not suitable for oral use). • Amoxicillin: Given orally (acid-stable). 3. Clinical Uses • Penicillin G: Used for severe infections like syphilis, meningitis, and bacterial endocarditis. • Amoxicillin: Used for mild-to-moderate infections like respiratory tract infections, UTIs, and otitis media. 4. Bioavailability • Penicillin G: Poor oral bioavailability. • Amoxicillin: High oral bioavailability, suitable for outpatient treatment. 5. Resistance • Penicillin G: More susceptible to β-lactamase-producing bacteria. • Amoxicillin: Slightly more resistant, especially when combined with clavulanic acid. 6. Half-life • Penicillin G: Shorter half-life, requires frequent dosing. • Amoxicillin: Longer half-life, less frequent dosing. 7. Combination Therapy • Penicillin G: Rarely combined with β-lactamase inhibitors. • Amoxicillin: Often combined with clavulanic acid (e.g., Augmentin).

Amoxicillin is used to treat the following diseases: 1. Upper respiratory tract infections (e.g., tonsillitis, pharyngitis caused by Streptococcus pyogenes) 2. Otitis media (middle ear infections) 3. Sinusitis 4. Pneumonia (caused by Streptococcus pneumoniae or Haemophilus influenzae) 5. Urinary tract infections (UTIs) 6. Skin and soft tissue infections 7. Helicobacter pylori infection (as part of combination therapy for peptic ulcer disease) 8. Endocarditis prophylaxis (in at-risk individuals undergoing dental procedures) 9. Typhoid fever 10. Bronchitis 11. Dental abscesses

Penicillin G is used to treat the following diseases: 1. Syphilis (Treponema pallidum) 2. Rheumatic fever (prophylaxis) 3. Bacterial endocarditis (caused by Streptococci) 4. Meningitis (caused by Neisseria meningitidis) 5. Pneumonia (caused by Streptococcus pneumoniae) 6. Diphtheria 7. Anthrax (Bacillus anthracis) 8. Gas gangrene (Clostridium perfringens) 9. Tetanus (Clostridium tetani) 10. Actinomycosis 11. Leptospirosis

Apki voice slow hai

Nephrotoxic

CMI Graft rejection Autoimmune disease Aplastic anemia

Cyclosporine cyclophilin complex

Cyclosporine Inhibit calcineurin Enhance TGF-B Decrease IL2

MHC2 CD4 TCR PLC PIP2 DAG IP3 Ca Calmodulin Calcineurin NFAT IL2 Proliferation Differentiation of T cells

CXR is Chest X ray

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#Farre

Passive No lag period Short lived Memory absent Useful in immunodeficienct host

IgG Placenta IgA Colostrum